Clinical Psychiatry News

Clinical Psychiatry News is a monthly medical and psychiatry tabloid published since 1973 by the International Medical News Group. Subjects for Clinical Psychiatry News include psychology and psychiatry. The executive editor is Denise Fulton, and Gina Henderson is a senior editor.

Articles from Vol. 31, No. 5, May

Add Lidocaine Patch to Gabapentin for Pain Relief. (Somnolence Is Most Common Adverse Event)
NEW ORLEANS -- The lidocaine patch improved pain relief for patients with postherpetic neuralgia, diabetic neuropathy, and low back pain in a study presented at the annual meeting of the American Academy of Pain Medicine. The 2-week, open-label,...
Adolescents with PDD Need Multimodal Tack. (Intellectual Development Is Key)
NEW YORK -- Adolescents with pervasive developmental disorder will benefit from a multimodal approach that addresses their intellectual development as well as emotional and social needs, Dr. Stephen B. Billick said at the annual meeting of the American...
Advocates Hope Report Stems Mental Health Crisis. (President's New Freedom Commission)
WASHINGTON -- As a presidentially appointed panel on mental health Completed its final report, advocates were Cautiously optimistic that the group's work would spur national action on the worsening national mental health services crisis. The first...
Anorexia-Promoting Sites Thrive. (Adolescent Medicine)
SEATTLE -- Web sites that promote anorexic behavior may outnumber sites with information on anorexia recovery by five to one, Dr. Eric B. Chesley reported at the annual meeting of the Society for Adolescent Medicine. Moreover, the anorexia nervosa-promotion...
Antidepressants and Pregnancy
The increasing number of reproductive-age women who are on antidepressants has raised concerns about the potential risks of teratogenicity, perinatal toxicity, and the long-term neurobehavioral sequelae of prenatal exposure to these medications. ...
Aripiprazole Benefits Are Sustained over Time. (Superior Side Effect Profile)
NEW YORK -- Two extended clinical trials have shown that the benefits of aripiprazole, the newest antipsychotic, endure and perhaps increase over time, Dr. W Gordon Frankle said at a conference on schizophrenia sponsored by Columbia University. ...
Behavioral TX Plus Sibutramine Sheds Pediatric Pounds but Has CV Risks. (Poor Quality of Life)
A weight loss drug prescribed for adults also helped obese children and adolescents lose weight when added to a behavioral weight loss program, but it was associated with significant cardiovascular side effects, reported Dr. Robert I. Berkowitz of...
Bioterrorism: Are We Ready?
My experience with the nation's first anthrax case taught me that we must better prepare our medical systems to respond to bioterrorism. Only through extensive training can we become prepared. Most communities are ill prepared to handle a bioterrorism...
Coenzyme Q10 for Parkinson's Disease. (Alternative Medicine)
* The dietary supplement coenzyme Q10 has shown some promise in the treatment of early Parkinson's disease, Huntington's disease, and as migraine prophylaxis. * Larger studies will be needed to determine optimal dosages and to confirm efficacy....
Cognition Can Be Improved in Schizophrenia. (Atypical Antipsychotics May Help)
COLORADO SPRINGS -- The central problem in schizophrenia isn't hallucination, delusion, or negative symptoms, but cognition--and it appears things can be done to improve it, Dr. Richard G. Petty declared at a symposium on addictive disorders sponsored...
Cognitive Deficits Undermine Schizophrenia Recovery. (Attention, Memory, Executive Function)
NEW YORK -- Cognitive deficits in schizophrenia have a marked impact on functional capacity, particularly when it comes to social behavior, Dr. Thomas B. Smith said at a conference on schizophrenia sponsored by Columbia University. Such deficits...
Dementia-Sensitive Culture' Lowers Aggression. (Keeps Patients out of Institutions)
BALTIMORE -- Preventing aggression in patients with dementia may keep them out of institutions, Cynthia D. Steele said at a meeting on Alzheimer's disease and other dementias sponsored by Johns Hopkins University. Aggression is less likely when...
Early Levodopa Seems to Slow Parkinson's. (9-Month Randomized Trial)
HONOLULU -- Fears that the use of levodopa in early Parkinson's disease might hasten the progression of the disorder have largely been put to rest by the results of a large clinical trial that Dr. Stanley Fahn reported at the annual meeting of the...
Extreme Squalor Presents a Therapeutic Challenge. (Formal Diagnoses Rare)
Jim Proffitt remembers the mummified kittens. "A family of kittens had moved into [a California man s] house and hid under something," Mr. Proffitt told this newspaper. "He had no idea they were there. He had so many opened cans and other junk lying...
FDA Proposes Bar Codes for Drugs, Blood Products. (Effort to Reduce Medication Errors)
WASHINGTON -- The Food and Drug Administration wants to require bar codes on the packaging of prescription drugs, blood, and blood products, a change officials say will dramatically reduce the estimated 770,000 medication errors that occur annually...
Fink! Still at Large: The Anxiety of Terrorism. (Opinion)
Some older patients remember the skittish days of "duck and cover." But the anxieties created by Sept. 11 and the war with Iraq are leading some of our younger patients to panic. Is there a difference in your treatment strategy based on the age of...
Help OCD Patients Learn to Tolerate Their Fears. (Cognitive TX Should Support Exposure)
TORONTO -- Cognitive therapy techniques should be used to help patients with obsessive-compulsive disorder develop a tolerance for uncertainty which is often the basis of their distorted thinking, Jonathan Grayson, Ph.D., said at the annual conference...
Herbal with Valerian Helps Treat Sleep-Onset Insomnia. (Double-Blind Study)
SALT LAKE CITY -- An herbal supplement containing valerian significantly improved sleep-onset insomnia, Paul J. Mills, Ph.D., reported at the annual meeting of the Society of Behavioral Medicine. In a double-blind, crossover study patients taking...
High-Potency Benzodiazepine Best for Panic. (Preferable to SSRIs)
TUCSON, ARIZ. -- Panic disorder can be treated with selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and tricyclics, but high-potency benzodiazepines have several advantages over antidepressants for this disorder. Compared...
HIPAA Rules Could Put a Chill on Office-Based Research. (Privacy Regulations)
ARLINGTON, VA. -- The now active privacy rule of the Health Insurance Portability and Accountability Act may make it more difficult and risky to conduct office-based research. The privacy rules regarding the use and disclosure of patient health...
HIV Is on Rise among Patients over Age 60: Substance Abuse, Personality Disorders Are Common among This Population. (Aging Complicates Problems)
HONOLULU -- Between 5% and 10% of HIV-infected persons in the United States are more than 60 years old, and their numbers are growing, Dr. Constantine Lyketsos said at the annual meeting of the American Association for Geriatric Psychiatry. Most...
Holistic Approach Eases Stress, PTSD. (Focus Is on Psychological Self-Care)
Nine months after the Sept. 11, 2001, disaster, Dr. James S. Gordon led a 3-day retreat for 63 New York City firefighters and their family members in New York's Catskill Mountains. The retreat, which was a domestic adaptation of the Center for Mind-Body...
How to Determine Driving Ability in Alzheimer's Disease. (MMSE, Grandchildren Test)
BALTIMORE -- Two simple tests can help convince reluctant families that it is time for a person with Alzheimer's disease to stop driving, Dr. Constantine G. Lyketsos said at a meeting on Alzheimer's disease and other dementias sponsored by Johns Hopkins...
In Brain Injury, Early Clinical Features Matter. (Each Patient Is Different)
RANCHO MIRAGE, CALIF. -- The severity of long-term sequelae after traumatic brain injury has to do with a host of factors, including previous psychiatric conditions, the type of damage incurred, and signs and symptoms in the early aftermath of an injury,...
Infection Control May Minimize Spread of SARS. (Travel History Essential)
Standard infection control precautions may have been key in minimizing the spread of severe acute respiratory syndrome in the United States, said Dr. Irwin M. Berlin, chief of pulmonary critical care at Elmhurst (N.Y) Hospital Center. "In retrospect...
Low-Intensity Exercise, Three Times per Week, of Little Cardiac Benefit. (Study of 492 Sedentary Adults)
SALT LAKE CITY - Physical activity must be either intense or frequent--preferably both--in order to exert cardiovascular benefits on sedentary individuals. Exercising at a moderate intensity only three or four times a week provides no cardiovascular...
Malpractice Crisis Breeds Fear, Distrust of System. (83% of Physicians Don't Trust System)
WASHINGTON -- Physicians are running scared from a legal system they no longer trust. A Harris Interactive poll of 300 physicians showed that 83% didn't trust the current system of justice to achieve a "reasonable result" if sued. Also, 79% of...
Medicare Payments Could Drop by 4.2% in FY 2004. (Preliminary Analysis)
The fee schedule giveth and the fee schedule taketh away That's the lesson many physicians may be about to learn. Last year, Herculean efforts by physicians and the organizations that represent them resulted in a 1.6% increase in the Medicare physician...
Memantine Can Cut Alzheimer's-Related Costs. (FDA Approval Expected by Year-End)
HONOLULU -- Memantine treatment could significantly cut the overall costs as sociated with Alzheimer's disease-currently estimated at $80 billion to $100 billion in the United States, R. Dhanda Ph.D., said in a poster presentation at the annual meeting...
Mental Health Problems Predominate in ADA Claims. (Creative Diagnoses)
RANCHO MIRAGE, CALIF. -- When the Americans with Disabilities Act was first enacted in 1990, the legislation was generally written for individuals with physical disabilities, requiring such protections as "reasonable accommodation" for employees in...
Modify Standard Cognitive Therapy Methods to Treat OCD. (Don't Neutralize Exposures)
TORONTO -- just a few modifications are needed to make standard cognitive therapy techniques effective tools for treating obsessive-compulsive disorders, Jonathan Grayson, Ph.D., and Harold Kirby said at the annual conference of the Anxiety Disorders...
Music, Exercise, and More Visitors May Fight Apathy as Well as Drugs. (Alzheimer's Disease)
BALTIMORE -- Nonpharmacologic interventions are at least as effective as drugs in the treatment of apathy in Alzheimer's disease, Dr. Chiadi Onyike said at a meeting on Alzheimer's disease and other dementias sponsored by Johns Hopkins University....
New Tool to Screen for Opioid Addiction Potential. (Interim Tool Available in June)
Clinical psychologists and experts in pain and addiction are collaborating to develop a novel screening tool aimed at identifying patients who may be at high risk for addiction to opioid therapy. The SOAP, or Screener for Opioid Addiction Potential,...
Novel Antipsychotic's Side Effect Profile Offers Benefits. (Neurotransmitter Systems Stabilized)
CHICAGO -- The pharmacologic profile of aripiprazole, an antipsychotic approved for the treatment of schizophrenia, predicts relative freedom from the side effects that have hampered use of the other atypicals. Emerging evidence suggests that this...
Olanzapine/fluoxetine Combination on the Way. (Bipolar Depression)
COLORADO SPRINGS -- Look for an olanzapine/fluoxetine combined formulation for treatment of bipolar depression to reach the marketplace in the next year or two, Dr. Willis Holloway said at a symposium on addictive disorders sponsored by Psychotherapy...
Opioids May Help Cognition in Noncancer Pain. (Oxycodone/Acetaminophen, Fentanyl)
CHICAGO -- Long-term use of certain opioids at stable doses does not significantly impair cognitive ability or psychomotor function in patients with chronic noncancer pain, Robert Jamison, Ph.D., said at the annual meeting of the American Pain Society....
Patients' 'Psychosocial Matrix' May Hold Clue to Resistant Depression. (Switching Drug Classes Unnecessary)
NEW YORK -- When addressing treatment-resistant depression, don't overlook the "psychosocial matrix of nonresponse" in patients whose lives work against their medication, Dr. Michael Thase said at a conference on psychopharmacology sponsored by New...
Physically Active Seniors Save Medicare Money. (Analysis of 5-Year Costs)
CHICAGO - Regular physical activity in seniors is associated with reduced Medicare health care costs, Dr. Russell V. Luepker reported at the annual scientific sessions of the American Heart Association. The value of regular exercise in later life...
Practical Psychopharmacology: Anxiety in Schizophrenia. (Psychopharmacology)
Historically, anxiety has gone undiagnosed and untreated in schizophrenia. "Because the primary disorder is so severe, all symptoms manifested by patients were regarded as part and parcel of the psychotic process, said Dr. Michael Y Hwang, director...
Pro & Con
Is the insurance cycle responsible for rising malpractice premiums? YES Medical malpractice claims have held steady yet insurance premiums have skyrocketed. This pattern can be attributed to the cyclical nature of the commercial insurance...
Prompt Intervention May Help Slow Dementia. (Caregiver Burden a Factor)
HONOLULU -- Early and judicious treatment of dementia may slow a patient's deterioration and delay or even eliminate the need for a nursing home, according to a presentation at the annual meeting of the American Association for Geriatric Psychiatry....
Psychiatrist Explores What Makes Terrorists Tick: Some Similarities Seen to War Heroes. (Fledgling Science)
RANCHO MIRAGE, CALIF. -- Terrorists appear to share several biopsychosocial traits with war, heroes--with some important distinctions, Dr. Ansar Haroun said at a special session of the annual meeting of the American College of Forensic Psychiatry....
Psychological Factors May Affect HIV Progression. (Two Studies)
PHOENIX, ARIZ. -- Two studies presented at the annual meeting of the American Psychosomatic Society show that psychological factors can affect the progression of HIV disease. One, a longitudinal study, showed that the depth of a patient's emotional...
PTSD 'Treatment Gap' Seen in New York City since Sept. 11. (Training Initiatives Help)
NEW YORK -- An insufficient number of mental health professionals trained in the treatment of posttraumatic stress disorder in New York City created a "treatment gap" in the city after Sept. 11, 2001, according to Dr. Randall Marshall. But that...
Rate of Tolerance in Opioid Therapy Is Higher in Younger Pain Patients. (Neuronal Pathways Key)
CHICAGO -- Neurons have to perform a great deal of "molecular gymnastics" in order to become tolerant to opioids, and that ability diminishes with age, Dr. Pamela Palmer said at the annual meeting of the American Pain Society. This diminished capacity...
Reel Life: Lone Star. (Psychotherapy)
John Sayles is virtually unique among American filmmakers: He believes that making a film should be a serious moral undertaking. Sayles' own moral sensibilities were formed in the 1960s and reflect the best aspirations of that generation: social activism,...
Relapses Are Likely for Anxiety Disorder Patients. (Long-Term Treatment Needed)
TORONTO -- Generalized anxiety disorder is a lifelong condition that usually requires long-term treatment, Dr. Alan J. Gelenberg said at the annual conference of the Anxiety Disorders Association of America. Studies show that after stopping treatment,...
Ropinirole May Resolve Refractory Fibromyalgia. (Unblinded Study)
MANCHESTER, ENGLAND -- Novel uses of dopamine agonists in fibromyalgia may herald the beginning of the end for treatment-refractory disease, Dr. Andrew J. Holman said at the annual meeting of the British Society for Rheumatology. Evidence of abnormal...
Routine Questions about Sex Are Important. (Older Adults)
HONOLULU -- "How's your sex life?" Many doctors never think to ask their older patients this question, despite the evidence suggesting that sex is an area of interest for many older adults who are living longer and healthier lives, Dr. Tomas L....
rTMS May Help Schizophrenics Shut out Voices. (for Some, Gains Persisted for Months)
NEW YORK -- Transcranial magnetic stimulation shows promise for one of the most persistent of schizophrenia symptoms--hallucinated voices, Dr. Ralph E. Hoffman said at a conference on schizophrenia sponsored by Columbia University. The modality,...
Saving the Safety Net
Politicians have long debated the need to fix our health insurance system. But if we are to meaningfully address the present crisis in health care costs, access, and quality, we must be willing to directly challenge the very underpinnings of the system...
Severe Adverse Events Tied to Supplement Use. (Prospective Study)
Inadequate surveillance and underreporting of adverse events associated with the unregulated use of dietary supplements are contributing to a substantial public health hazard. In a prospective study in which 11 U.s. poison control centers reported...
Severe Head Trauma May Signal Abuse in Young Children. (under Age 5 Years)
CHICAGO -- Accidental falls rarely produce significant head injuries, Dr. Karl Johnson said at the annual meeting of the Radiological Society of North America. "In our experience, if it's an accident, most children will fall over, they may cry a...
SF-36 Survey May Assess Depression in Chronic Pain. (238 Consecutive Patients)
NEW ORLEANS -- The SF-36 health survey might be a useful clinical tool for assessing depression as well as overall quality of life in chronic pain patients, Dr. Thomas Elliott reported during a poster presentation at the annual meeting of the American...
Smallpox Adverse Reactions Cover Broad Range. (Mild Lesions Reassuring)
CHICAGO -- With adverse reactions to smallpox vaccine making headlines and with more than 25,600 health care workers vaccinated so far, it's important for clinicians to understand and be able to recognize adverse reactions to the inoculation, said...
Solo Practice Requires Time, Money, Patience. (Availability, Affability, Ability)
HONOLULU -- Establishing a solo practice requires time, money, fortitude, and a near-obsessive attention to detail, according to Dr. Sandra Swantek. But it can be a rewarding option for doctors who are frustrated by the politics or loss of control...
SSRI-Caused Sexual Dysfunction: Patient Education Is Key. (Clinical Trial Data Limited)
SAN DIEGO -- "Sexual functioning is complex--and so is talking about it with your patients," Dr. Robert K. Schneider observed at the annual meeting of the American College of Physicians. "Educating the patient about the relevance of this information...
Stick to the Basics in Fitness for Duty Exams. (ADA Employment Cases)
RANCHO MIRAGE, CALIF. -- Psychiatrists called upon to perform a "fitness for duty" mental examination on an employee need to remember three things: Do your homework, maintain objectivity, and honor the employee's privacy, said James J. McDonald, an...
Supratherapeutic Dosing of Olanzapine May Help Refractory Schizophrenia. (Improved Social Functioning)
COLORADO SPRINGS -- Supratherapeutic doses of olanzapine achieve at least moderate benefit in many severely ill schizophrenic patients who are refractory to multiple trials of conventionally dosed typical and atypical antipsychotic agents, Dr. John...
Teach Patients to Share Medical Issues with Family, Friends. (Secrecy vs. Privacy)
KIAWAH ISLAND, S.C. -- Societal pressures that blur the distinction between privacy and secrecy can serve to deny patients the support they need, Evan Imber-Black, Ph.D., said at a meeting sponsored by the Society of Teachers of Family Medicine. ...
Tobacco Settlement Money Getting Sidetracked. (Funds Not Going for Prevention)
ST. LOUIS -- When the nation's top tobacco companies agreed to a settlement that would pay 46 states hundreds of billions of dollars in 1998, policy-makers and antismoking advocates hailed the deal as a tool to drastically reduce smoking and its related...
Topiramate Clears Psoriasis in Mood Disorder Patients. (Study of Seven Patients)
Topiramate, an antiepileptic drug, was highly successful in the treatment of psoriasis in a small pilot study of eight individuals. All but one of the patients responded to the treatment in the study, and, in the seven patients who did respond,...
Universal Autism Screening for Children by Age 2 Is 'Practical Goal,' Expert Says. (Diagnosis by Age 4 Deemed Too Late)
KOHALA, HAWAII -- Every toddler should be screened for autism, because early behavioral therapy can make a difference, Dr. Martin Stein said at a meeting sponsored by the American Academy of Pediatrics. He believes that physicians should consider...
Unusual Symptoms May Signal Psychogenic Pseudostroke. (Serious Recent Stressors Common)
PHOENIX, ARIZ. -- A sequential evolution of stroke-like symptoms, unusual exam features, and recent stressors may point to psychogenic pseudostroke, an "uncommon but not rare condition" seen in a widely disparate group of patients, Dr. Timothy C. Lukovits...
U.S. Stroke Risk Mapped out Down to the County Level. (Atlas of Stroke Mortality)
The Stroke Belt has been mapped out--in great detail. For the first time, the Centers for Disease Control and Prevention has released data on stroke mortality broken down to the county level. The data, which are from 1991 to 1998, are further broken...
Violence Tied to Substance Abuse Risk. (Self-Reported Data)
Witnessing or being a victim of violence significantly increases a teenager's risk for substance abuse, reported Dr. Robert Vermeiren of the University of Antwerp (Belgium) and his associates. This finding suggests that clinicians should screen...
Withdrawal, Anger Flag Decline into Schizophrenia. (Harbinger of Psychosis in Adolescents)
NEW YORK -- An insidious and inexplicable decline in a "normal but vulnerable" individual appears to be the most common pattern among adolescents with prodromal symptoms of schizophrenia, according to a family study reported at a conference on schizophrenia...
Years after Sexual Abuse by Priests, Psychic Sequelae Remain for Men. (Depression, Substance Abuse Common)
NEW YORK -- Children and adolescents who are sexually abused by priests are extremely likely to suffer from depression and substance abuse later in life. Many have been suicidal, and most experience ongoing problems in their spiritual and sexual lives....
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